COVID-19 is now a household name. Everyone has heard of the of the disease and its dangers and the need to take precautions. We know we have to follow the advice of the Health Ministry and limit our movements to reduce the spread of the disease. Different countries have experienced different challenges but all are saddled with significant economic hardships and unprecedented difficulties in leading normal lives.
What is seldom highlighted is the plight of those who suffer in silence when not provided the urgent medical care that they need. While we appreciate and agree with the need to postpone elective surgeries, I find that many of our healthcare staff are uncertain about what is meant by “elective surgery”. Elective surgeries
should mean surgeries that can be safely postponed without major adverse consequences to the patient. This does not include cancer surgeries.
In Malaysia, both public and private hospitals have been directed to limit or postpone various clinical services and make available intensive care beds, ventilators and personal protective equipment. Healthcare professionals are required to stand by to manage any surge of Covid-19 cases. Most of the non-Covid-19 hospitals in both the public and private sector in the Klang Valley have ceased all elective surgeries, creating tremendous confusion among surgeons and patients alike, as different healthcare providers have different interpretations of what “elective” means. The directives from the Health Ministry are vague, and some hospital managements have decided to shut down almost all clinical services except emergencies.
We strongly feel that the non-Covid-19 hospitals should continue to perform urgent clinical and emergency services including cancer surgeries and interventions while taking the necessary precautions to minimise the risk of the nosocomial spread of Covid-19 to patients and healthcare workers.
Abruptly stopping “non-essential” procedures and surgeries would prevent diagnoses of life-threatening diseases with grave consequences to those affected.
Dr Scott Atlas of Stanford University in the United States wrote that “people are dying because other medical care is not getting done due to hypothetical projections. Critical healthcare for millions of Americans is being ignored and people are dying to accommodate ‘potential’ Covid-19 patients and for fear of spreading the disease”.
While Malaysia is doing well in controlling the spread of Covid-19 cases, we must not abdicate our responsibility to all other patients who need urgent treatment like cancer surgeries, removal of arterial blockages, relieving biliary obstructions and managing potential sepsis and others. We need to be aware that some surgeries may not be considered emergency surgeries but not doing them is, nevertheless, life threatening.
I have been informed that clinical services in non-Covid-19 hospitals are beginning to open up again, but the significant backlog of cases would require prioritisation of services rendered. Patients should not be shuffled around or shunned for whatever reason.
Healthcare providers must help save as many lives as possible and refrain from being judgemental. Our healthcare system must continue to provide care for all irrespective of any unprecedented crisis.
TAN SRI DR ISMAIL MERICAN , Former Health director-general Kuala Lumpur
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